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PLD OF SOUTH CITY PC
NPI 1871479758
Dentist - General Practice in Saint Louis, MO

Active since August 14, 2025
3859 GRAVOIS AVE, SAINT LOUIS, MO 63116(314) 382-2000(314) 382-2411 Get Directions Write a Review

NPPES record last updated: May 7, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: May 7, 2026, Aug 14, 2025 (2 updates tracked since 2025).

About Pld Of South City Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PLD OF SOUTH CITY PC (NPI 1871479758), doing business as Pine Lawn Dental, is a healthcare organization registered as a general practice in Saint Louis, Missouri and active in the NPI registry since August 2025. The organization lists Michael Travis, Owner, as its authorized official.

NPPES Registry Identity

NPI1871479758
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NamePLD OF SOUTH CITY PC
Location Address3859 GRAVOIS AVESaint Louis, MO 63116-4657
Mailing Address3708 Jennings Station RdSaint Louis, MO 63121-3500 · (314) 382-2000 · Fax (314) 382-2411
Phone(314) 382-2000
Fax(314) 382-2411
Organization SubpartNo
Authorized OfficialMichael TravisOwner · (314) 635-0822
Enumeration DateAugust 14, 2025
Last NPPES UpdateMay 7, 20262 updates tracked since enumeration
NPPES CertifiedMay 7, 2026
✔ NPI 1871479758 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
3859 GRAVOIS AVE, Saint Louis, MO 63116
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Other Names 1

Doing Business AsPine Lawn Dental

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BRANDON NICHOLAS PAPPAS DDS
Dentist (General Practice)
3859 GRAVOIS AVE
SAINT LOUIS, MO 63116
St. Louis City (314) 912-3604
JOSEPH PAUL FERGUSON DDS
Dentist
3859 GRAVOIS AVE
SAINT LOUIS, MO 63116
St. Louis City (314) 382-2002

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Pld Of South City PC's NPI number?

The NPI number for Pld Of South City PC is 1871479758. It was assigned to this organization in the NPPES registry on August 14, 2025. The provider is doing business as Pine Lawn Dental.

Where is Pld Of South City PC located?

Pld Of South City PC is located at 3859 Gravois Ave, Saint Louis, MO 63116. The listed phone number is (314) 382-2000.

What is Pld Of South City PC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

When was this NPI record last updated?

The NPPES record for Pld Of South City PC was last updated on May 7, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.